摘要
目的探讨指腹缺损行指动脉逆行岛状皮瓣术后8年的临床疗效。方法回顾性分析我院自2013年1月至2015年12月采用指动脉逆行岛状皮瓣修复指腹缺损患者19例,均为单指受伤。示指7例,中指8例,环指3例,小指1例。结果所有的皮瓣以及植皮区域均有色素沉着。15例患者对皮瓣修复满意,2例一般,2例不满意。均无寒冷不耐受情况。按照中华医学会手外科学会上肢部分功能评定试用标准评定:优15例,良4例。伤指远指间关节周径,伤指近、远指间关节主动活动度,皮瓣静态两点分辨觉对比健侧同指差异有统计学意义。感觉恢复评定S有7例,S3有12例。结论指动脉逆行岛状皮瓣是指腹缺损的修复选择之一,具有血运可靠、操作简单等特点。虽然随访时感觉恢复略差,但可以接受。术后需要加强功能锻炼以解决关节活动受限的问题。如何解决色素沉着也是需要关注的问题之一。
Objective To investigate the clinical efficacy of reverse digital artery island flap surgery for finger pulp defects for 8 years.Methods A retrospective analysis was conducted on 19 patients with finger pulp defects repaired using a reverse digital artery island flap in our hospital from January 2013 to December 2015,all of whom were single finger injuries.There were 7 cases of index finger,8 cases of middle finger,3 cases of ring finger,and 1 case of little finger.Results All skin flaps and graft areas showed pigmentation.15 patients were satisfied with the flap repair,2 were average,and 2 were dissatisfied.No cold intolerance was observed.According to the evaluation criteria of the Chinese Society of Hand Surgery for upper limb function,15 cases were rated as excellent and 4 cases were rated as good.The circumference of the distal interphalangeal joint of the injured finger,the active range of motion of the proximal and distal interphalangeal joints of the injured finger,and the static two-point discrimination of the skin flap showed statistically significant differences compared to the healthy side of the same finger.There were 7 cases of sensory recovery assessment S3 and 12 cases of S3+.Conclusion The reverse digital artery island flap is one of the repair options for digital pulp defects,which has the characteristics of reliable blood supply and simple operation.Although there was a slight improvement in sensory recovery during follow-up,it was acceptable.Postoperative functional exercise is necessary to address the issue of limited joint mobility.How to solve pigmentation is also one of the issues that needs attention.
作者
陆一鸣
王斌
戚仁竞
顾加祥
刘宏君
Lu Yiming;Wang Bin;Qi Renjing;Gu Jiaxiang;Liu Hongjun(Department of Foot and Hand Surgery,Dalian Medical University Yangzhou Clinical College,Jiangsu Subei People's Hospital,Yangzhou 225000,China)
出处
《中华手外科杂志》
CSCD
北大核心
2024年第4期341-344,共4页
Chinese Journal of Hand Surgery
关键词
指损伤
治疗结果
指动脉逆行岛状皮瓣
长期随访
Finger injuries
Treatment outcome
Reverse digital artery island flap
Long-term follow-up
